Death rate for U.S. children falls

August 04, 2007|By Frank Greve, McClatchy Newspapers

WASHINGTON - Things are looking up for Dr. Catherine Webb, a pediatric cardiologist at Northwestern University in Chicago. “When I was in training in the '80s, this was a pretty depressing specialty,” she said. “But it's not anymore.” True enough. The death rate from heart disease among children is about half what it was in 1980, according to a compendium of federal child-health statistics released last month. Also down by roughly half are children's death rates from birth defects, cancer, heart disease, pneumonia and flu, as well as injury-related child deaths from motor vehicle accidents, drowning, fires, falls, firearms and suffocation. Death rates from all causes dropped 53 percent among children ages 1 to 4 and 45 percent among children ages 5 to 14. It adds up to survival for about 8,000 children a year who would've died in 1980. “It's terrific news,” said Harry Rosenberg, retired chief of the Mortality Statistics Branch of the National Center for Health Statistics, which is part of the Centers for Disease Control and Prevention. Better medicine and new safety measures get much of the credit. So does expanded government health-insurance coverage for disadvantaged children, which gives them better access to medical care. Parents deserve credit, too, said Dr. Frederick Rivara, a professor of pediatrics at the University of Washington in Seattle who specializes in injury reduction. They're drinking and smoking less, for example, which reduces birth defects, fires and car crashes. “Parents have gotten away from the idea that accidents happen and can't be prevented,” Rivara said. “They know that child safety seats save lives and bike helmets prevent head injuries. They believe, as parents, that they can protect their kids. And that's a big change.” Not all good news: Only one leading killer - homicides - hasn't relented significantly. “They're abuse cases, really,” Rivara said. All racial groups showed similar declines from 1980 to 2004 - the latest year reported - but the death rate for black children remained nearly 40 percent higher when compared with those for Hispanics, Asians and non-Hispanic whites. Also troubling: Most declines flattened by 2000, for unexplained reasons. Different explanations underlie each decline. Here are some of the key ones:

Motor vehicles: Deaths down from 7.4 to 3.3 per 100,000 for kids ages 1 to 4; down from 7.5 to 3.7 for kids ages 5 to 14. Safer cars are a factor, but child safety seats and booster seats are the big difference. Used properly, safety seats cut child fatalities by 71 percent, according to the National Highway Traffic Safety Administration. Tennessee became the first state to require child safety seats in 1978. By 1985, all states did.

Birth defects: Deaths down from 8.0 to 3.6 per 100,000 for children ages 1 to 4; down from 1.6 to 1.0 for children ages 5 to 14. Improved prenatal diagnoses are a big factor, according to Dr. Howard Saal, the director of clinical genetics at Children's Hospital Medical Center in Cincinnati and a professor of pediatrics at the University of Cincinnati College of Medicine.

Fires and burns: Deaths down from 6.1 to 1.5 per 100,000 for children ages 1 to 4; down from 1.5 to 0.7 for children ages 5 to 14. Low-cost smoke alarms helped the most, said John R. Hall, chief research analyst at the National Fire Protection Association in Quincy, Mass. They've been found to cut fire-injury rates by as much as 80 percent.

Drownings: Deaths down from 5.7 to 2.8 per 100,000 for children ages 1 to 4; down from 2.5 to 0.7 for children ages 5 to 14. The vast majority of infant and toddler drownings occur in backyard pools, according to Sue Gallagher, the director of the Tufts Medical School's Health Communication Program in Boston. In the 1970s, Australia found that effective fencing can reduce those deaths by 80 percent. U.S. jurisdictions followed suit. McClatchy Researcher Tish Wells and Jeanette Hudson, senior librarian for the Children's Safety Network in Newton, Mass., contributed to this report.